Ninety-three patients with previously untreated pathologically documented stage III or IV non-Hodgkin's lymphomas were randomized to receive either CVP (high dose cytoxan plus vincristine and prednisone) or CAVP (adding Adriamycin with a somewhat lower dose of cytoxan) every three weeks. The median followup is 3.5 years. The histologies of all patients have been reviewed and classified according to both the Rappaport and new International schemes. The CR rate was 51% in both arms. Remission duration and survival were also similar. However, in diffuse histiocytic lymphoma and in the comparable category G (diffuse large cell) of the new formulation, there was a distinct advantage to CAVP which gave a 60% CR rate in DHL and 67% CR in category G. CVP produced only 10% CR in these categories (p=.057). Eighty-six percent of CR's remained free of disease at a median of 3.75 years. Thus, a survival advantage was seen for CAVP in DHL. For the other diffuse histologies and all nodular histologies, there was no significant difference between the regimens, although there was a trend in favor of CVP for nodular patients.